Organization
LIFECARE PHARMACY LLC
Active
Other names
LifeCare Specialty Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
CLETUS ONYE AMADI R.PH. (PHARMACIST /OWNER)
(702) 697-2105
Entity
Organization
Contact information
Practice address
3050 E DESERT INN RD STE 124, LAS VEGAS, NV 89121-3873
(702) 697-2105
(702) 697-2107
Mailing address
3050 E DESERT INN RD STE 124, LAS VEGAS, NV 89121-3873
(702) 697-2105
(702) 697-2107
Taxonomy
Speciality
Code
Description
License number
State
251F00000X
Home Infusion Agency
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336H0001X
Home Infusion Therapy Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1972603827
—
NV
01
—
2052110
PK
—
Enumeration date
09/22/2006
Last updated
02/10/2023
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